Midline Lumbar Spine decompression (for spinal stenosis) surgical technique
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Lumbar spine decompression is undertaken for spinal stenosis where non operative management has failed and the neurogenic claudication (or radicular) type symptoms are sufficiently severe to warrant the risks of spinal surgery. A patient is always counselled on the non-operative management options and should under normal circumstances have had a trial of these. Spinal stenosis is an age related condition which may become more prevalent as the population ages.
Lumbar spine decompression is indicated where leg symptoms are interfering with current enjoyment of life and may well be reducing exercise tolerance or simply the ability to walk. Any back pain should be manageable and non-specific (in other words no causative pathology identified).
The MRI should have confirmed the diagnosis of lumbar spinal stenosis.
The surgical steps in undertaking a midline sacrificing lumbar decompression are described here from set up through to post operative care.
Author: Mr Andrew Young FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham, UK.
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Question 1 of 10
Neurogenic claudication will usually have the following clinical symptoms that can help differentiate it from vascular claudication. Which one of these is the most likely clinical scenario?CorrectIncorrect
Question 2 of 10
When undertaking lumbar decompression for spinal stenosis which one of the following is the safest practice?CorrectIncorrect
Question 3 of 10
Regarding intraoperative level checking. Which one of the following describes the best practice?CorrectIncorrect
Question 4 of 10
During the exposure for a lumbar decompression which one of the following statements is correct ?CorrectIncorrect
Question 5 of 10
The L4/5 level is exposed for a single level decompression. Regarding the facet joint anatomy which of the following is most true?CorrectIncorrect
Question 6 of 10
Which one of the following should not appear on the post op instructions after uneventful lumbar spine stenosis decompression?CorrectIncorrect
Question 7 of 10
Patients should give informed consent to any elective surgical intervention. Regarding the aim of decompression for lumbar spinal stenosis which of the following is true?CorrectIncorrect
Question 8 of 10
Dural tears are a known complication of lumbar decompression. In the primary (non revision) setting which of the following describes the approximate dural tear rate?CorrectIncorrect
Question 9 of 10
Lumbar decompression may be undertaken without fusion for spinal stenosis. Which one of the following statements describes the key differentiator in terms of outcome What is the difference?CorrectIncorrect
Question 10 of 10
Midline lumbar decompression at L2/3 may include the following except which?CorrectIncorrect